Rate of digestion of foods and postprandial glycaemia in normal and diabetic subjects.

Jenkins, David; Wolever, Thomas M. S.; Taylor, R.; Ghafari, Hamid Reza; Jenkins, Alexandra L.; Barker, Helen M.; Jenkins, Mathew J.

doi:10.1136/bmj.281.6232.14

Cited by 155 publications

(71 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Data from acute and chronic feeding studies suggest that pulses reduce both postprandial blood glucose and insulin excursions [46,48,50,51], effectively lowering the GI of the diet through slowed absorption [11,67,68]. A direct benefit on measures of insulin sensitivity has also been reported for pulses alone using surrogate HOMA indices [50,51] and has been implied by studies of pulses in low-GI diets using the euglycaemic-hyperinsulinaemic clamp [27].…”

Section: Discussionmentioning

confidence: 88%

Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes

et al. 2009

View full text Add to dashboard Cite

Aims/hypothesis Dietary non-oil-seed pulses (chickpeas, beans, peas, lentils, etc.) are a good source of slowly digestible carbohydrate, fibre and vegetable protein and a valuable means of lowering the glycaemic-index (GI) of the diet. To assess the evidence that dietary pulses may benefit glycaemic control, we conducted a systematic review and meta-analysis of randomised controlled experimental trials investigating the effect of pulses, alone or as part of low-GI or high-fibre diets, on markers of glycaemic control in people with and without diabetes. Methods We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for relevant controlled trials of ≥7 days. Two independent reviewers (A. Esfahani and J. M. W. Wong) extracted information on study design, participants, treatments and outcomes. Data were pooled using the generic inverse variance method and expressed as standardised mean differences (SMD) with 95% CIs. Heterogeneity was assessed by χ 2 and quantified by I 2 . Meta-regression models identified independent predictors of effects. Results A total of 41 trials (39 reports) were included. Pulses alone (11 trials) lowered fasting blood glucose (FBG) (−0.82, 95% CI −1.36 to −0.27) and insulin (−0.49, 95%

show abstract

Section: Discussionmentioning

confidence: 88%

Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes

et al. 2009

View full text Add to dashboard Cite

show abstract

“…In turn the digestibility of foods has been shown to be reduced by the presence of enzyme inhibitors [39], lectins [40] and phytates [41], all of which are contained in beans. In vitro studies of cooked legumes have indeed shown that these are digested less rapidly than other carbohydrate foods [37,42].…”

Section: Discussionmentioning

confidence: 99%

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

et al. 1983

View full text Add to dashboard Cite

Summary. Recently diabetic patients have been encouraged to increase their carbohydrate intake, but exact details of which foods to use are lacking. To determine whether sufficiently large differences existed to justify more specific dietary advice, we compared the glycaemic responses to 50 g carbohydrate portions of different foods, taken as breakfast test meals by groups of five to seven diabetic patients. Two-to threefold differences were seen amongst the 15 foods tested. The glycaemic responses for spaghetti, 'All-bran', rice and beans were significantly below those for bread, while 'Cornflakes' were above. Factors predicted to influence this were without effect, including: substituting wholemeal for white bread, increasing substantially the simple sugars (using 'All-bran' or bananas instead of wholemeal bread) and doubling meal protein by adding cottage cheese to bread. Paired comparisons of the glycaemic response to the five legumes with those of the seven other starchy foods (breads, spaghetti, rice, Cornflakes, oatmeal porridge and potatoes) showed that the mean peak rise in blood glucose concentration and mean area under the glucose curve after beans were 23 and 28% lower, respectively, than the mean for the other foods (p < 0.001). Such results suggest a potentially valuable role for dried leguminous seeds in carbohydrate exchanges for individuals with impaired carbohydrate tolerance. These large differences in the blood glucose response to different food cannot at present be predicted directly from tables of chemical composition. Nevertheless, physiological testing may both aid in understanding the factors responsible and help selection of the appropriate carbohydrate foods for the diabetic diet.Key words: Glycaemic index, leguminous seeds, low blood glucose rise, diabetes, diabetic diet, fat, sugars, protein.To lessen the risk to the diabetic of carciovascular disease, current dietary guidelines of the American [1] and Canadian [2] Diabetes Associations and the British Diabetic Association [3] have recommended increasing complex carbohydrate and fibre intakes, while reducing fat consumption. Exactly how this should be achieved is not known and there are fears that increased intake of specific foods, or carbohydrates in general, may worsen diabetic control [4]. However, in the context of high fibre diets this does not appear to be the case [5]. Indeed studies using purified fibre and high-fibre, high-carbohydrate diets have been associated with improved diabetic control [9][10][11][12][13][14][15]. Nevertheless, the carbohydrate foods of greatest potential use to the diabetic have not as yet been defined and it has now been acknowledged that information on the glycaemic effect of individual foods and meals is urgently needed [3].We have therefore compared the effect of taking 50 g carbohydrate portions of 15 different foods on the blood glucose responses of diabetic patients. We wished to determine whether large differences existed which favoured the use of particular foods. It was also important to s...

show abstract

“…One core recommendation in US as well as in Europe is to build a healthy food base for healthy eating and to promote a daily, high intake of a variety of whole grain products, fruits and vegetables (United States Department of Agriculture and United States Department of Health and Human Service, 2000). A major feature that appears to determine the metabolic effect of grain products and starchy foods is the rate at which these starchy foods are digested (Jenkins et al, 1980b). Carbohydrate food, which is more slowly digested, results in reduced glucose and insulin responses (O'Dea et al, 1981;Jenkins et al, 1982).…”

Section: Introductionmentioning

confidence: 99%

Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects

et al. 2004

View full text Add to dashboard Cite

Objective: To investigate the effect of a rye, high-fibre diet (HFD) vs a wheat, low-fibre diet (LFD), meal frequency, nibbling (Nib, seven times a day) or ordinary (Ord, three times a day), and their combined effects on blood glucose, insulin, lipids, urinary C-peptide and ileal excretion of energy, cholesterol and bile acids in humans. Design: LFD period with Nib or Ord meal frequency followed by an HFD diet with Nib or Ord meal frequency in randomized, crossover design. Setting: Outpatients of ileostomy volunteers were called for an investigation in research word. Subjects: A total of 10 subjects (two female subjects, age 34 and 51 y; eight males, mean age 54.4 y, range 43-65 y) participated in the experiment. All subjects were proctocolectomized for ulcerative colitis (mean 16.0 y, range 8-29 y before the study). Intervention: In total, 10 ileostomy subjects started with LFD for 2 weeks, the first week on either Nib (five subjects) or Ord (five subjects) and the second week on the other meal frequencies, in a crossover design, followed by a wash-out week, and continued with HFD period for 2 weeks in the same meal frequency manner. All foods consumed in both Nib or Ord regimens were identical and a high-fibre rye bread was used in the HFD period and a low-fibre wheat bread in the LFD period. Main outcome measures: Day-profiles of blood glucose, insulin and lipids, blood lipids before and after dietary intervention, and excretion of steroids in the effluents and C-peptide in the urine. Results: During the Nib regimen, plasma glucose and insulin peaks were lower at the end of the day with HFD compared with LFD. Urinary C-peptide excretion was significantly higher in the day-time on LFD compared with HFD (LFD-Ord vs HFD-Ord, Po0.01; LFD-Nib vs HFD-Nib, Po0.01). Plasma free-cholesterol, total cholesterol, triglycerides and phospholipids were significantly higher (Po0.05) after LFD than after HFD with the Nib regimen. A higher excretion of energy (Po0.05) and chenodeoxycholic acid (Po0.05) were observed with HFD compared with LFD regardless of meal frequency. A higher daily excretion of cholic acid, total bile acids, cholesterol, net cholesterol and net sterols (Po0.05) was observed on HFD compared with LFD with the Nib regimen. Conclusions: An HFD decreased insulin secretion measured as a decreased excretion of C-peptide in urine and as decreased plasma insulin peaks at the end of the day during a Nib regimen. The smoother glycaemic responses at the end of the day during a Nib regimen may be a consequence of a second meal phenomenon, possibly related to the nature of dietary fibre complex. Contributors: EAL and JXZ were responsible for the study design, conducting the dietary intervention, completing the statistical analysis and writing the paper. PT was responsible for the study design and conducting the dietary intervention of the study. DL was involved in the advisory of writing the paper and the analysis of the blood lipids. PÅ was involved in the concept and planning, and the analysis of the nutrients in the...

show abstract

Rate of digestion of foods and postprandial glycaemia in normal and diabetic subjects.

Cited by 155 publications

References 3 publications

Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes

Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects

Contact Info

Product

Resources

About